539 - A Pilot Study Examining the Association of Parental Stress and Household Food Insecurity with Dietary Quality in Pre-School Aged Children

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 539
Publication Number: 539.118

Madison McCarthy, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Mara Z. Vitolins, Wake Forest University School of Medicine, Winston -Salem, NC, United States; Joseph Skelton, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Edward H.. Ip, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Caroline B. Lucas, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Callie L. Brown, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States

Presenting Author(s)

Callie L. Brown, MD, MPH (she/her/hers)

Assistant Professor
Wake Forest School of Medicine of Wake Forest Baptist Medical Center
Winston-Salem, North Carolina, United States

Background: Adequate dietary variety is necessary for appropriate cognitive and physical development in young children and may be influenced by parental and family factors.

Objective: To assess the associations of parental stress and household food insecurity (HFI) with a child’s dietary quality.

Design/Methods: As part of a larger study on feeding practices of healthy 3-5-year-old children, we conducted a pilot study with 24 children to assess dietary quality. Parents completed three 24-hour dietary recalls by phone (2 weekday, 1 weekend day) and nutrient composition was averaged. The Healthy Eating Index (HEI) was calculated to assess overall dietary quality, which considers 10 components (grains, vegetables, fruits, milk, meat, saturated fat, total fat, cholesterol, sodium, variety). Parents completed a questionnaire to assess parental stress (Perceived Stress Scale (PSS)) and HFI (2-item Hunger Vital Sign screen). Children’s height and weight were measured and BMIz score calculated. We used two sample T-tests to assess differences in dietary quality components by HFI status. Unadjusted linear regression assessed differences in dietary quality components by parent stress. Separate multivariable linear regression models assessed correlates of dietary quality components, including HFI, parental stress, household income, child sex, and child BMI z-score.

Results: Children had diverse race/ethnicity (42% Black, 42% white, 17% Hispanic) and income (33% < $20K, 29% $20-60K, 38% $60K+); 12.5% had HFI. Children had overall low dietary quality with mean HEI score 55.2 (SD 10.9). In bivariate analysis, overall dietary quality was not associated with HFI status, however, children with food insecurity consumed more added sugars (Table 1). In bivariate analysis with parent stress, only greens and beans were associated with parent stress such that for each 1-point increase on the PSS, the child’s total vegetable score was 1.6 points lower (p=0.01). In multivariable analysis, HFI was associated with lower total protein scores and higher added sugar intake, and parent stress was associated with lower greens and beans intake. Higher income was associated with total vegetable and sodium intake, and higher BMIz with total protein (Table 2).

Conclusion(s):

Parental stress and HFI can impact a child’s dietary quality; specifically, we found they consumed less greens and beans and total protein and more added sugars. Interventions to address poor dietary variety in children should consider parent and family factors such as HFI and parental stress.